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In that example, you can use it either with or without 'an', but as 'an' doesn't add anything, I'd omit it. However, strictly speaking, '(an) amputation is needed' could mean either that:
* all of the leg should be amputated; or that
* sth else (say, just part of it – the foot, the knee or whatever) should be amputated.
It all depends on whether sth else, or just the leg, has been specified in the previous paragraph(s). If it has and you want to be more precise, you can say '(The leg/The foot/The knee/whatever) needs to be amputated'. Otherwise, just put 'amputation is needed'.
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